I can’t help but share this great commercial involving gynecomastia.  Any sports fan should love this.  We are seeing more and more gynecomastia patients, and more male patients in general here in our Santa Barbara plastic surgery practice.  Treatment of gynecomastia with liposuction can be very successful, with or without the addition of an excision of some tissue when needed.  I’m happy to answer any questions that any of you may have about this very treatable cosmetic condition.

In the course of my discussions about creating the most natural appearing breast augmentations, I always review the reasoning that I use the dual plane technique with my patients.  A lot of information about breast implants can be found on the breast pages of my website, but I want to reiterate why this technique seems to give the best  and most natural breast contour.

The pectoralis muslce is a broad, flat muscle that extends from the proximal humerus, at the top of the arm near the shoulder, down to the breast bone and central rib cage.  Classically, breast implants have been placed either above or below this muscle.  Most often breast implants are currently placed under this pectoralis muscle because it tends to have a lower rate of complications.  This is called the sub-muscular position.  The disadvantage to putting the breast implant in this position is that the attachment of the pectoralis muscle to the rib cage and the breast tissue can tend to hold the implant in a relatively high position, giving the un-natural appearance of excess fullness, or a shelf, in the upper portion of the breast.

While some plastic surgeons will release the lower portions of the muscle in order to aid in preventing the breast implant from remaining high, the dual plane technique adds a further dissection releasing the lower portions of the breast from the muscle.  This allows the implant to fall into the relaxed breast tissue behind the nipple.  With the implant in this position, the apex of the breast implant lies where the best projection of the breast should be- at the region of the nipple.  The muscle remains to cover the upper portion of the breast implant, and creates a lovely transition from the breast apex to the upper chest wall.  The resulting tear drop form allows a very natural appearing breast augmentation, and a very happy patient.  Best of all, this dual plane technique retains a very low complication rate.

Feel free to come and have some further discussion on this breast augmentation technique, and be sure to review our photo gallery for some examples of woman who have had natural appearing breast augmentation with me in Santa Barbara.

Yesterday the United States Preventive Services Task Force released new guidelines for recommended breast cancer screenings in women, revising the suggested age for mammograms to 50 from 40 and decreasing the frequency of such tests to every two years rather than the previous annual exam. This government-appointed panel of medical experts, which provides guidance on public health concerns to both doctors and insurance companies, found there was sufficient new data to warrant the changes in policy. These new guidelines do not apply to women who are considered to be at higher risk for breast cancer than the general population, such as those with previous chest radiation or a family history of cancer.

At the forefront of the new guidelines was data collected from studies conducted in England and Sweden, which indicated there was little increased benefit in yearly screening versus screening every two years. Meanwhile, multiple cancer-oriented organizations, such as the American Cancer Society, are strongly opposing these new recommendations.  As technology evolves, what is clear is that screening recommendations will continue to evolve.  New studies such as precision ultrasound and MRI are becoming increasingly frequent modalities for breast cancer detection, and this is particularly true in our local community where our breast screening radiologists are so well regarded.  As for my own recommendations, I feel that the needs for various screening techniques and protocols are specific enough from patient to patient that each individual should discuss the pros and cons of early mammography screening with their primary care doctor, and proceed in the manner that makes them most comfortable. My practice will continue to remain very involved in breast reconstruction until the day that we all hope comes, when those services are no longer needed.

We are seeing more and more women come from Beverly Hills and Hollywood to have their plastic surgery in Santa Barbara.  I find this a very interesting phenomenon.  I’ve never been one to gawk at celebrities- I see them as people just like you and I, with very interesting careers.  (I have some friends, whoever, that I’m convinced only visit me both here in Santa Barbara and also at my home in Aspen because they like to see and be seen with the rich and famous.)  Personally, I feel that privacy issues are of ultimate importance, and as I refuse to divulge anything about my patients (more…)